Social Security Denied Me For SSD But Didn’t Have All My Medical Records, What Do I Do?

How to prove you are disabled
and win disability benefits

Social Security disability examiners do not necessarily have to have all of an individual’s medical records to make a medical decision on a claim. Disability examiners are obligated to request the records from all medical treatment sources provided by the disability applicant. However, they do not have to wait until they have all the records received to make their determination. Logically, there will always be some medical sources that are extremely slow about providing medical records. Or, they may not provide them at all. So disability examiners are allowed to make a medical decision if they feel there is enough current medical evidence in file to make their determination.

If an applicant is denied for disability benefits, they have a right to file an appeal of that decision. All medical sources that are used in the medical determination are notated in the disability denial notice. If the applicant believes that some medical records were not used for their disability determination, they can always provide the medical records when they file an appeal of their disability denial.

If the disability applicant cannot send in physical copies of the medical records with their appeal, they should make sure that they write down the missing medical treatment provider (a doctor's office or hospital) on the disability report form for their appeal, so that there is another opportunity for these records to be included in the disability medical determination.

As a former disability examiner, I can say that the medical records that disability applicants feel are pivotal to their disability decision are often not that integral to the actual disability decision.

For example, if the medical records were from a treatment source that treated the disability applicant several months or years in the past, they are not going to have much of an impact on the disability determination. Disability examiners have to focus on what an individual is currently able to do in spite of the limitations imposed upon them by their disabling condition. Frankly, medical records from a year ago are not going to be very helpful. Functionality is key in all Social Security disability determinations, and that is why having all medical records received at the time of the medical determination is not as important as one might think.

However, if an individual feels that their missing medical records would have made a difference to their disability determination, they should make every effort to just include the missing medical records with their appeal. This way they will be sure that the information will be considered as part of the medical determination for the appeal.

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SSD and SSI are Federal Programs

The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

Recent approval and denial statistics for various states can be viewed here:

Social Security Disability, SSI Approval and Denial Statistics by state

Special Section: Disability Lawyers and unnecessary claim denials